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Wednesday, 24 November 2010
Page: 3588


Ms ROWLAND (12:01 PM) —I am very pleased to rise and speak in support of the Federal Financial Relations Amendment (National Health and Hospitals Network) Bill 2010. It is a subject very close to my heart. My interest in public health is a long one. Ten years ago I put my hand up to be a community representative on the then Western Sydney area health service and I learned a lot about the fundamentals of health economics. I learned about emergency department access blocks, I learned about triage and I learned about bed funding. I learned about preventive health and that sometimes the most effective spending is the spending that keeps people out of hospital, preventing them from having to actually need treatment in the first place.

The Labor Party has always been the party of health reform. We have also promoted the importance of a universal and quality healthcare system. The Curtin Labor government began funding public hospitals for the first time and it was the Chifley Labor government that introduced legislation to create a public health system, paving the way for the creation of Medibank and subsequently Medicare. The Whitlam Labor government legislated for the introduction of Medibank, a precursor to a universal public health system. And the Hawke and Keating Labor governments enshrined universality into the heart of our healthcare system by introducing Medicare. I am proud to be a member of a government that is continuing Labor’s strong tradition of health reform.

In contrast, the Liberal Party make it quite clear that they do not share this belief in the importance of universal health care, and it is evidenced by their negativity in this debate today. They have a history of repeatedly scrapping vital health programs and cutting funding for health services—a shameful tradition that would have continued if they had won the last election. The health policies of Robert Menzies simply led to uncapped fee-for-service medicine and inadequate rural medical services. The coalition constantly opposed the Whitlam government’s legislation to introduce Medibank and when they were in government from 1975 to 1983, they undermined the scheme, removing any semblance of universality.

When in government the then opposition displayed absolute contempt for our health system. Bulk-billing rates plummeted and $1 billion was cut from our public hospitals. The blame game not only continued, it became worse, to the detriment of constituents. And Australia was left with a shortage of 6,000 nurses and a queue of 650,000 people on public dental waiting lists, with 2,300 older Australians being left in hospital beds every night because of the shortage of aged care beds. Had they won the last election, they would have cut GP superclinics, which are designed to take pressure off hospital emergency departments and provide quality health care when it is needed. This would have hurt residents in my electorate of Greenway, where a $15 million GP superclinic is being built in Blacktown. I am very pleased that the tender process for this very important project has in fact commenced, and it is being widely welcomed by the people of Greenway. Indeed, the Liberal Party showed a complete and utter disregard for the healthcare needs of residents in Western Sydney. We are always the afterthought in their eyes. The local Liberal Party candidate, for example, claimed that an Abbott government would not cut the proposed Blacktown GP superclinic, completely contradicting his own party’s policy. He refused to participate in a community health forum organised by nurses at Blacktown Hospital, which I was very happy to participate in. The contrast between the Labor and conservative parties on the issue of health care could not be clearer and it is on display in this debate.

This debate also gives me the opportunity to again discuss something very close to my heart—the issue of Blacktown Hospital. For the benefit of those here, it is very useful to take into account the enormous scale of Blacktown Hospital, serving residents in Blacktown, which is the largest local government area in New South Wales and I think now the third-largest in Australia. Each year Blacktown Hospital treats more than 35,000 people in its emergency department. It has approximately 24,500 patients staying at least one night in hospital. It performs 8,000 surgical procedures, provides 214,000 outpatient services and assists with the birth of more than 3,300 babies—a rate that continues to increase as Greenway continues to be Australia’s nursery. The catchment area is absolutely enormous and, taking all that into account, it is therefore with responsiveness to the people whom I represent in this place that I am very pleased that we are having a $15 million GP superclinic built. We have the $17.6 million construction of the University of Western Sydney’s clinical school and research and education centre at Blacktown Hospital, which will train more doctors and nurses and health professionals in Western Sydney and, importantly, will train local students. Local students being trained locally means that they are more likely to stay and serve the people with whom they live. There is $4.2 million for 18 additional beds at Blacktown Hospital, which includes six new acute beds, and $854,000 for new equipment at Blacktown Hospital, including a new defibrillator, heart monitoring and breathing machines and urological equipment. Given all these things, I am very pleased that I am able to look my constituents in the eye and say that I am doing my bit to deliver for them the health services they need.

I am very pleased to support the bill before the House because I know that it will continue Labor’s proud tradition of health reform. This bill represents transformational reform, and nothing represents transformational reform more than the benefits of the National Broadband Network. I draw the attention of the House to a public document, a report commissioned by the Department of Broadband, Communications and the Digital Economy on the impact of high-speed broadband for e-health. Some very interesting and instructive items come out of this report.

The department requested this report on the financial and externality impacts of ubiquitous high-speed broadband—in other words, what the NBN precisely is—and, in particular, the impacts that would result from the increased use of things such as telemedicine for remote consultations, remote home based monitoring of chronic disease patients and the aged, and remote training of health professionals. The conclusion that this study came to was that the estimated steady-state benefits to Australia from wide-scale implementation of tele-health using ubiquitous high-speed broadband may be in the vicinity of $2 billion to $4 billion per annum. Every year those benefits will accrue to the Australian public. When you multiply that and think about how that money could be invested in hospitals, you can see that this one aspect of the NBN has benefits that clearly mean that the quality of people’s lives is going to be very directly impacted in a positive way.

I draw the attention of the House to a couple of items raised in the report. I did mention chronic disease. Over two-thirds of health expenditure in Australia is consumed by chronic disease. The report very interestingly points out that chronic conditions are ideally suited to remote monitoring. Conditions commonly covered by remote monitoring include cardiovascular disease—the Blacktown local government area has one of the highest rates of cardiovascular disease in New South Wales—diabetes, cancer, infections, skin injuries, and the list goes on.

These are benefits in terms of not only chronic disease but also, in a very real sense, social inclusion. The Australian e-Health Research Centre has pointed out that using tele-ophthalmology for diabetes prevention in remote settings is particularly well suited to delivery over high-speed broadband networks. This is significant given Australia’s Indigenous population has one of the highest rates of diabetes in the world. So when we talk about social inclusion, when we talk about bridging the gap, we can see how high-speed broadband for tele-health can directly benefit those in our society who are the most vulnerable and continue to be the most vulnerable.

This bill implements significant changes to federal financial arrangements in order to implement key aspects of the National Health and Hospitals Network agreement that was endorsed on 20 April 2010. As we have heard, the Commonwealth will take responsibility for funding the majority of Australia’s health and hospital systems. This is vital in order to stop the blame game. As I go around my constituency on a daily basis I am continually told that the blame game must stop. The blame game between the state and federal governments needs to end in order for constituents to have the highest quality health care system.

Unless we address these health funding arrangements, our health and hospital system will simply struggle to keep pace with our growing and ageing population. The Intergenerational Report released in January of this year shows that the proportion of our population aged over 65 is forecast to increase from 14 per cent this year to 23 per cent by 2050, and 5.1 per cent of the population is projected to be over the age of 85 by 2050. This will lead to an increased number of people requiring services and treatment to help with dementia, mobility, hearing, eyesight and general frailty. Meeting these needs will require not only additional services but also more expenditure in the area of health. The report also highlights that the ageing population and population growth itself will account for approximately 40 per cent of the expected increase.

State and territory governments cannot deny reality. Their revenue levels do not grow as fast as hospital costs. State government budgets will simply be crippled by the weight of rising health care costs and the quality of our system will suffer as a result. Indeed, some commentators have warned that entire state budgets risk being consumed by health and hospital costs unless reform is undertaken. That is why this government is taking action to reform our health system.

The Commonwealth will dedicate one-third of total GST allocations to health and hospital spending and will fund 60 per cent of the efficient price for all public hospital services and 60 per cent of capital, research and training in our public hospitals. The Commonwealth will also assume full funding and policy responsibility for GP and primary healthcare services and for aged care services.

I am very pleased to speak in support of this bill because I know that residents in my electorate of Greenway will directly benefit from these significant reforms. As I have said, unless the reforms occur we will not have a health system that will be able to cope into the future. In fact, one week after the COAG agreement was reached the Commonwealth and New South Wales governments announced the additional 18 new beds that I mentioned, totalling $4.2 million, for Blacktown. I was present when that was signed, in the old building of Blacktown Hospital where I was born so it was certainly a very significant day for me and here we are at a very significant point in reforming Australia’s public hospital systems.

It is crucial that the National Health and Hospitals Network bill is passed by the parliament to ensure that west and north-west Sydney continue to benefit from the additional resources that will flow. I am extremely concerned that failure to pass this bill will have hugely significant negative implications for Australia’s health and hospital system. The opposition’s refusal to support this legislation will directly hurt my local community.

Let us be clear: a vote against this legislation is a vote against more funding to provide more hospital beds, more doctors and more nurses for communities across Australia; a vote against this legislation is a vote against addressing the significant challenges posed by the ageing population; a vote against this legislation will simply place short-term political opportunism ahead of the national interest. As I said at the outset of my contribution, there is a fundamental difference between Labor and Liberal governments when it comes to health care and certainly it is on display today. We on this side of the House believe in and value the importance of a quality healthcare system. Those opposite do not. This legislation ensures our proud legacy of health reform continues.

I will go into the break being able to look my constituents in the eye and say that I have put up my hand to ensure that we end the blame game when it comes to hospital funding, that I did my bit to ensure that they received the highest quality health care. I urge those opposite to do the same today so that they can go back in the break and do the same in their own electorates.